Welcome User. This game will help you learn general ideas and definitions about insurance. The more choices you make the more you will know. Navigate through that game by clicking on the hihglighted links. Occasionally you will need to make a choice, click on the link you wish to choose. You can begin this journey of discovery by playing as the character Rachel Davis.
[[Rachel Davis->Beginning 1]]Sunshine peaked through the clear windows and settled on my face. Then it proceeded to burn my eye sockets so I promptly woke up.There are not many days that I get to sleep in, my 26th birthday wouldn't be one of [[them.->continue]] Most 26 year olds get a new car or go on vacation. I get to sign up for Private health insurance. Yay, the props to working two-part time jobs and niether of your employers will cover your health insurance. I don't have the time to call a broker so I think I'll apply [[online]]. I've used computers before so this should be no big deal right? According to the Affordable Healthcare Act there should be open enrollment for private health insurance which I need because I'm not covered by my parent's insurance anymore. As I scroll through the Google search page I click on the link [[open enrollment healthcare]].This link takes me to a site that seems fairly simple. I have to enter my personal information like social security, who I live with (no one at the time), and how much I make in a year (currently 40,000). The first thing it gave me was a [[tax credit estimate]].This estimate was a guess based on my salary and other information on how much money the government woud give me to help in purchasing insurance. With my current salary I estimated $167 in tax credit to put towards my premium [[plan->plans]]. Keeping that estimate in mind I finally got to compare the health insurance plans offered in my state. There were high [[*deductible plans]] with low [[*premiums]] and every single plan included [[*co-pay]] and [[*co-insurance]]. I do not usually get sick or injured and I do not have a lot of money to spare every month when I have to pay for rent, food, and my online classes. Based on this info I narrowed it down to two choices...
[[Platinum Plan]] Premium- $500 (with tax credit $333), Deductible- $250, Copay- $20, Coinsurance- 15%
- The Premium Plan will pay for ER visits, ambulance rides, and hospital stays. Most Medications will be covered unless otherwise confirmed as unneccesary according to stipulation. This plan enables customers to have a wide range of coverage.
[[Bronze Plan]] Premium- $250 (wih tax credit $83), Deductible- $1,500, Copay- $40, Coinsurance- 30%
-The Bronze Plan will pay for hospital stays and ER visits as well as most medications deemed needfull by your doctor. This plan ensures a low monthly payment for our customers. A deductible is the total amount of money you personally pay for your medical care before your insurance will contribute. For example, if your deductible is $2000 you have to pay that before your insurance will cover anything. Often times after your deductible is paid you are then held responsible to pay your [[*co-pay]] and [[*co-insurance]].A premium is what you pay every month for an insurance plan. Usually the higher your premium the lower your deductible will be. Bronze plans have low premiums high deductibles and platinum plans have hihg premiums with low deductibles.Well I feel old now. Definietly different than the feeling I had on my 21st birthday. I cannot believe that application took me all [[day->tragedy]].*Well I feel old now. Definitely different than the feeling I had on my 21st birthday. I cannot believe that application took me all [[day-> tragedy]].*A co-pay is a flat-rate amount you pay every time you go in for something simple like a doctors visit or to get medication. However, copayments in most cases are only made after a person's deductible has been reached. If you're deductbile is say $1,500 then you have to pay that amount of money every year or so before your insurance will kick in and start helping you. After your insurance kicks in you will pay a co-payment for things like medication or simple doctor visits.Co-insurance is a percentage of the medical bill that patients will have to pay. This is onyl applied after a clients deductible has been paid. An example would be if you got a $10,000 surgery. If your co-insurance is 20% then you would pay $2,000 and your insurance would pay $8,000.I woke up to the sound of my blaring alarm and not the frying of eye sockets. I quickly got dressed and prepared for my 8:00 am shift at the local Denny's. It wasn't much but I like being a part-time cook. I think we had a new waitress starting today. I loved watching newbies they always are a bit [[clutzy...]] Rachel: "Hey Cherise!"
Cherise: "Hey Rachel how ya doin Hon?"
*Cherise is my all time favorite person. She's been at the diner basically since it opened. She's the head waitress and she's actually the one that got me promoted to cook after she recommended me to the big boss. I guess it's because she's been like my mom away from home.*
Rachel:"Just ready for the morning grind! Is the coffee started or should I get a move on?"
Cherise: "Oh don't you worry about that darlin you know coffee's ma thang."
Rachel: "You are a life saver Cherise. What would I do without you?"
Cherise: "I dunno but it wouldn't be very fun."
Rachel: "Well said. I'm going to start my morning checks, holler if you need me!" With a wink I said, "Oh and good luck with that newbie today."
Cherise: "If only luck was in high supply"
*I chuckled to myself and started my usual rounds of prep for all the equipment. The best part about working the diner is I only have to start the day, so often I'm not in charge of cleanup.
*I finally got through the morning rush of truckers and their dark brewed coffee. It was finally lunch time and let me tell ya I can make a mean batch of [[fries...]]*Order up- special fry with a thickburger!
*** You turn to start the fries and right as you reach for the fryer you feel a push from behind. Instinctively you stick your hand out to stop yourself, you watch in horrer as your left hand submerges into the hot oil. Screaming pain shoots up your arm everything fades to black as you feel the tug of someone pulling you [[away...->hospital]] *You wake up to the fervent smell of hand sanitizer and the smell of smoked bacon*
"Where am I ?"
Nurse: "You're in the hospital Hon. You got some nasty burns on your left hand."
"That freaking newbie!"
Nurse:" You are lucky we got you when we did we might have had to amputate. You were rushed into the ER and the Doctor had to operate right away to save as many nerve endings in your hand as we could."
Rachel: " Oh, How long is recovery?"
Nurse: "Oh I didn't think we got off on that bad a foot! You'll most likely be released in a few days, so don't get bored with me just yet. We want to make sure you are stable and have some mobility in your hand. After that you'll need physical therapy and most likely a few prescriptions, a full recovery could last [[months...]]"I was released from the hospital about a week later. I got so sick of that place I decided to pick up my prescriptions another day. I also had a Physical Therapy appointment at the end of the week, which I was just Golly-dang looking forward too. When I got home I noticed the bills had already come [[in...->Bills]]As I unfolded the letter I did not have too much dread because I payed for a platinum plan. Everything should be fine.
The list of paymetns rolled out before me.
Hospital Stay of 5 days................$10,000
Nerve ending Surgery...................$200,000
ER admittance............................$200
Ambulance Ride.........................$1,000
Total: $211,200
31,462.5
Your deductible (auto charged to your account) = $250
Insurance will cover in full: ER admittance, Ambulance Ride, Hospital Stay =$11,200
Total= ($211,200-$250)-$11,200= $199,750
Co-insurance will cover (85%)=(85%)($199,750)= $169,787.50
Your final payment will be: $29,962.50
If you have questions please make an inquery to the contacts below:
Insurance Plus: Alec Boroski
801-999-5473
Hospitals United: Janice Smith
801-275-0265
[[Thank You. Have a nice Day!]]
I couldn't stop the tears from falling. There was no way. I only make $40,000 a year and that's with two part time jobs. I would be homeless and starving if I tried to pay that off in one go. My only option would be some type of payment plan, but the only thing I could think about was my job. Would they even let me back in to work with a scarred up hand like this? Who should I call?
[[My Boss]]: Jack Bomont
801-982-4928
[[Insurance Plus]]: Alec Boroski
801-999-5473Jack: "Hey Rachel how are you? I was so scared when they rushed you to the hospital is your hand ok?"
Rachel: "Yeah I'm ok I still have a hand. You should see my medical bills it might have been better if I just lost it haha."
Jack: "Who would cook the best fries known to any Denny's chain?"
Rachel: "Right about that, can I still work at Denny's? I have some mild scarring but if I wear extra gloves it'll be like it never happened."
Jack: "I've been thinking about that and I want you to not worry about it you have been with us so long that firing you would mean more loss than gain. You're one of the best employees we have!"
Rachel: "I still have a job?"
Jack: "YES Rachel you still have a job."
[[Continue-> Insurance]]*I hesitantly dial the numbers into the phone.*
Alec: "Hello this is Alec Boroski, How can I help you?"
Rachel: "Hi this is Rachel Davis, I recently bought an insurance plan from your company and I have some questions."
Alec:"Awesome can I please have your insurance number that you were given when you made the purchase?"
Rachel:"Yes, the number is 46487623969."
Alec: "Ok I see you purchased our Premium plan an excellent choice and you recently had a hospital visit?"
Rachel:"Yes I got a severe burn on my hand from a workplace accident."
Alec: "OK what was your question about your Premium policy?"
Rachel:"So my hospital bill in total was $211,200 and after my deductible and co-insurance agreement it says I still owe $29,962.50 there is no way I can afford this. My question is why wasn't this covered in full if it was an emergency visit and surgery? "
Alec: "According to your policy we are required to cover in full every ER trip and Ambulance usage after your deductible. If you look at your [[bill->Bills]] you will see that we did in fact cover that visit and ambulance in full. The only problem is that the hospital you were taken to was in network, but the doctor who performed your surgery was out of network. Since the doctor was out of network we are not in charge of the full payment but rather this situation will divert us to use the co-insurance where you pay 15% and we pay 85% of whatever that bill will be."
Rachel: "I don't understand I was unconscous I had no ability to choose my doctor or hospital."
Alec: "I'm sorry ma'am I cannot help you. The only help I can offer is to reccomend you call the hospital and see what payment plans are available for your bill. Thank you. Have a Nice Day!"
*With that final statement I heard the dial tone ring in my ear*
[[Continue-> Choice]]With the dial tone ringing in my ear I had a choice to make. Do I call my Boss to make sure I still have a job or do I call the hospital to find a payment plan?
[[Call my Boss-> My Boss]]: Jack Bomont
[[Call the Hospital]]: Janice SmithJack: "Hey Rachel how are you? I was so scared when they rushed you to the hospital is your hand ok?"
Rachel: "Yeah I'm ok I still have a hand. You should see my medical bills it might have been better if I just lost it haha."
Jack: "Who would cook the best fries known to any Denny's chain?"
Rachel: "Right about that, can I still work at Denny's? I have some mild scarring but if I wear extra gloves it'll be like it never happened."
Jack: "I've been thinking about that and I want you to not worry about it you have been with us so long that firing you would mean more loss than gain. You're one of the best employees we have!"
Rachel: "I still have a job?"
Jack: "YES Rachel you still have a job."
Rachel:"Thank you Jack I'll be at work tomorrow!"
Jack:"Can't wait see you there!"
*WIth two down and one to go i started dialing the [[hospital's number]].*Janice:"Hello this is Janice Smith with Hospitals United. How can I help you? "
Rachel:"Hi this is Rachel Davis I was recently a patient at your hospital and my insurance told me to call you to set up a payment plan of some sort."
Janice:"Yes you've come to the right place. None of our payment plans include interest but you do have to make a payment every month. Our minimum payment plans are dependent upon your hospital bill. It says under your file that after insurance you have a remaining $29,962.50 that needs to be paid can you please confirm that?"
Rachel: "Yes that would be me."
Janice: "Ok awesome this high of a payment means that your payment plan will be based off of your yearly salary. What is your yearly salary Rachel?"
Rachel:"Between two jobs I make $40,000 a year."
Janice: "Ok since your bill is so high compared to your salary we will customize your payment plan by only making the yearly cost of payments equal to 5% of your salary. This means you will be paying $2,000 a year until the bill is paid. This means you will owe the hospital $167 dollars every month. Of course you can pay more than that, but that is your minimum payment plan."
Rachel: "OH thank you soo much. You have noe idea how much this helps!"
*With what seemed a billion tons lifted off my back I called my [[boss->IHB]] in high spirits.*
With a small glimmer of relief I decided i should probably call my insurance and see if there was anything I could do about my remaining medical bill.
[[Call Insurance]]: Alec Boroski*I hesitantly dial the numbers into the phone.*
Alec: "Hello this is Alec Boroski, How can I help you?"
Rachel: "Hi this is Rachel Davis, I recently bought an insurance plan from your company and I have some questions."
Alec:"Awesome can I please have your insurance number that you were given when you made the purchase?"
Rachel:"Yes, the number is 46487623969."
Alec: "Ok I see you purchased our Premium plan an excellent choice and you recently had a hospital visit?"
Rachel:"Yes I got a severe burn on my hand from a workplace accident."
Alec: "Ok what was your question about your Premium policy?"
Rachel:"So my hospital bill in total was $211,200 and after my deductible and co-insurance agreement it says I still owe $29,962.50 there is no way I can afford this. My question is why wasn't this covered in full if it was an emergency visit and surgery? "
Alec: "According to your policy we are required to cover in full every ER trip and Ambulance usage after your deductible. If you look at your [[bill->Bills]] you will see that we did in fact cover that visit and ambulance in full. The only problem is that the hospital you were taken to was in network, but the doctor who performed your surgery was out of network. Since the doctor was out of network we are not in charge of the full payment but rather this situation will divert us to use the co-insurance where you pay 15% and we pay 85% of whatever that bill will be."
Rachel: "I don't understand I was unconscous I had no ability to choose my doctor or hospital."
Alec: "I'm sorry ma'am I cannot help you. The only help I can offer is to reccomend you call the hospital and see what payment plans are available for your bill. Thank you. Have a Nice Day!"
*With that final statement I heard the dial tone ring in my ear*
Confused, frustrated, and certaintly not happy I took a couple deep breaths before I called the [[hospital...->Final option]]Janice:"Hello this is Janice Smith with Hospitals United. How can I help you? "
Rachel:"Hi this is Rachel Davis I was recently a patient at your hospital and my insurance told me to call you to set up a payment plan of some sort."
Janice:"Yes you've come to the right place. None of our payment plans include interest but you do have to make a payment every month. Our minimum payment plans are dependent upon your hospital bill. It says under your file that after insurance you have a remaining $29,962.50 that needs to be paid can you please confirm that?"
Rachel: "Yes that would be me."
Janice: "Ok awesome this high of a payment means that your payment plan will be based off of your yearly salary. What is your yearly salary Rachel?"
Rachel:"Between two jobs I make $40,000 a year."
Janice: "Ok since your bill is so high compared to your salary we will customize your payment plan by only making the yearly cost of payments equal to 5% of your salary. This means you will be paying $2,000 a year until the bill is paid. This means you will owe the hospital $167 dollars every month. Of course you can pay more than that, but that is your minimum payment plan."
Rachel: "OH thank you soo much. You have no idea how much this helps!"
*I had found a way out! Maybe this bill wouldn't be so bad after all. That night I quickly fell [[asleep...->Stage 3]]*
Jack: "Hey Rachel how are you? I was so scared when they rushed you to the hospital is your hand ok?"
Rachel: "Yeah I'm ok I still have a hand. You should see my medical bills it might have been better if I just lost it haha."
Jack: "Who would cook the best fries known to any Denny's chain?"
Rachel: "Right about that, can I still work at Denny's? I have some mild scarring but if I wear gloves it'll be like it never happened."
Jack: "I've been thinking about that and I want you to not worry about it you have been with us so long that firing you would mean more loss than gain. You're one of the best employees we have!"
Rachel: "I still have a job?"
Jack: "YES Rachel you still have a job."
*I saw bright hope as I got off that phone [[call...]]**It seemed like all I would be losing would be a couple hundred bucks and if I was careful I wouldn't have any other accidents that year. I might even end up with a gnarly Halloween hand at the end of this. Maybe I better start looking at casual gloves. None the less my pillow awaited and so did anotehr day at [[work...->Stage 3]].*Janice:"Hello this is Janice Smith with Hospitals United. How can I help you? "
Rachel:"Hi this is Rachel Davis I was recently a patient at your hospital and my insurance told me to call you to set up a payment plan of some sort."
Janice:"Yes you've come to the right place. None of our payment plans include interest but you do have to make a payment every month. Our minimum payment plans are dependent upon your hospital bill. It says under your file that after insurance you have a remaining $29,962.50 that needs to be paid can you please confirm that?"
Rachel: "Yes that would be me."
Janice: "Ok awesome this high of a payment means that your payment plan will be based off of your yearly salary. What is your yearly salary Rachel?"
Rachel:"Between two jobs I make $40,000 a year."
Janice: "Ok since your bill is so high compared to your salary we will customize your payment plan by only making the yearly cost of payments equal to 5% of your salary. This means you will be paying $2,000 a year until the bill is paid. This means you will owe the hospital $167 dollars every month. Of course you can pay more than that, but that is your minimum payment plan."
Rachel: "OH thank you soo much. You have noe idea how much this helps!"
*With a crisis averted I fell asleep before my head hit the [[pillow...->Stage 3]]* *I entered the Denny's parking lot and took a few breaths before I worked up the courage to walk through the door. The lights were off which was odd because I could have sworn I wasn't the only one in the parking [[lot...->SURPRISE]]*I woke up to the sound of my blaring alarm. Fighting the sleep in my eyes, I quickly got dressed and prepared for my 8:00 am shift at the local Denny's. It wasn't much but I like being a part-time cook. I think we had a new waitress starting today. I loved watching newbies they always are a bit [[clutzy...-> clutzy]] *Rachel: "Hey Cherise!"
Cherise: "Hey Rachel how ya doin Hon?"
*Cherise is my all time favorite person. She's been at the diner basically since it opened. She's the head waitress and she's actually the one that got me promoted to cook after she recommended me to the big boss. I guess it's because she's been like my mom away from home.*
Rachel:"Just ready for the morning grind! Is the coffee started or should I get a move on?"
Cherise: "Oh don't you worry about that darlin you know coffee's ma thang."
Rachel: "You are a life saver Cherise. What would I do without you?"
Cherise: "I dunno but it wouldn't be very fun."
Rachel: "Well said. I'm going to start my morning checks, holler if you need me!" With a wink I said, "Oh and good luck with that newbie today."
Cherise: "If only luck was in high supply"
*I chuckled to myself and started my usual rounds of prep for all the equipment. The best part about working the diner is I only have to start the day, so often I'm not in charge of cleanup. I finally got through the morning rush of truckers and their dark brewed coffee. The blessed time of lunch approached and let me tell ya I can make a mean batch of [[fries...-> fries]]* Order up- special fry with a thickburger!
*** You turn to start the fries and right as you reach for the fryer you feel a push from behind. Instinctively you stick your hand out to stop yourself, you watch in horrer as your left hand submerges into the hot oil. Screaming pain shoots up your arm everything fades to black as you feel the tug of someone pulling you [[away...->Hospital]]. ***You wake up to the fervent smell of hand sanitizer and the smell of smoked bacon
"Where am I ?"
*** You see a nurse to your left injecting something into a bag
Nurse: "You're in the hospital Hon. You got some nasty burns on your left hand."
"That freaking newbie!"
Nurse:" You are lucky we got you when we did we might have had to amputate. You were rushed into the ER and the Doctor had to operate right away to save as many nerve endings in your hand as we could."
Rachel: " Oh, How long is recovery?"
Nurse: "Oh I didn't think we got off on that bad a foot! You'll most likely be released in a few days, so don't get bored with me just yet. We want to make sure you are stable and have some mobility in your hand. After that you'll need physical therapy and most likely a few prescriptions, a full recovery could last [[months...->Months]]"I was released from the hospital about a week later. I got so sick of that place I decided to pick up my prescriptions another day. I also had a Physical Therapy appointment at the end of the week, which I was just Golly-dang looking forward too. When I got home I noticed the bills had already come [[in...->bills]]As I unfolded the letter I was still a little nervous after all I had only purchased a Bronze plan. I held my breath as the list of payments rolled out before me.
Hospital Stay of 5 days................$10,000
Nerve ending Surgery...................$200,000
ER admittance............................$200
Ambulance Ride.........................$1,000
Total: $211,200
31,462.5
Your deductible (auto charged to your account) = $1,500
Insurance will cover in full: ER admittance and hospital stay
Total= ($211,200-$1,500)-$10,200= $199,500
Co-insurance will cover (70%)=(70%)($199,550)= $139,685
Your final payment will be: $61,365
If you have questions please make an inquiry to the contacts below:
Insurance Plus: Alec Boroski
801-999-5473
Hospitals United: Janice Smith
801-275-0265
[[Thank You. Have a nice Day!->Nice Day]]
I couldn't stop the tears from falling. There was no way. I only make $40,000 a year and that's with two part time jobs. I would be homeless and starving if I tried to pay that off in one go. My only option would be some type of payment plan, but the only thing I could think about was my job. Would they even let me back in to work with a scarred up hand like this? Who should I call?
[[My Boss->big b]]: Jack Bomont
801-982-4928
[[Insurance Plus->insurance plus]]: Alec Boroski
801-999-5473Jack: "Hey Rachel how are you? I was so scared when they rushed you to the hospital is your hand ok?"
Rachel: "Yeah I'm ok I still have a hand. You should see my medical bills it might have been better if I just lost it haha."
Jack: "Who would cook the best fries known to any Denny's chain?"
Rachel: "Right about that, can I still work at Denny's? I have some mild scarring but if I wear extra gloves it'll be like it never happened."
Jack: "I've been thinking about that and I want you to not worry about it you have been with us so long that firing you would mean more loss than gain. You're one of the best employees we have!"
Rachel: "I still have a job?"
Jack: "YES Rachel you still have a job."
*I hun gup that call with a [[smile...->Insurance]]*I hesitantly dial the numbers into the phone.*
Alec: "Hello this is Alec Boroski, How can I help you?"
Rachel: "Hi this is Rachel Davis, I recently bought an insurance plan from your company and I have some questions."
Alec:"Awesome can I please have your insurance number that you were given when you made the purchase?"
Rachel:"Yes, the number is 02759259365."
Alec: "Ok I see you purchased our Bronze plan an excellent choice and you recently had a hospital visit?"
Rachel:"Yes I got a severe burn on my hand from a workplace accident."
Alec: "Ok what was your question about your Bronze policy?"
Rachel:"So my hospital bill in total was $211,200 and after my deductible and co-insurance agreement it says I still owe $61,365 there is no way I can afford this. My question is why wasn't this covered in full if it was an emergency visit and surgery? "
Alec: "According to your policy we are required to cover in full, every ER trip and Hospital stay after your deductible. If you look at your [[bill->bills]] you will see that we did in fact cover that visit and ambulance in full. The only problem is that the hospital you were taken to was in network, but the doctor who performed your surgery was out of network. Since the doctor was out of network we are not in charge of the full payment but rather this situation will divert us to use the co-insurance where you pay 30% and we pay 70% of whatever that bill will be."
Rachel: "I don't understand I was unconscious I had no ability to choose my doctor or hospital."
Alec: "I'm sorry ma'am I cannot help you. The only help I can offer is to recommend you call the hospital and see what payment plans are available for your bill.[[Thank you. Have a Nice Day!"->Choice ]]
With a small glimmer of relief I decided I should probably call my insurance and see if there was anything I could do about my remaining medical bill.
[[Call Insurance->CI]]: Alec Boroski*I hesitantly dial the numbers into the phone.*
Alec: "Hello this is Alec Boroski, How can I help you?"
Rachel: "Hi this is Rachel Davis, I recently bought an insurance plan from your company and I have some questions."
Alec:"Awesome can I please have your insurance number that you were given when you made the purchase?"
Rachel:"Yes, the number is 02759259365."
Alec: "Ok I see you purchased our Bronze plan an excellent choice and you recently had a hospital visit?"
Rachel:"Yes I got a severe burn on my hand from a workplace accident."
Alec: "Ok what was your question about your Bronze policy?"
Rachel:"So my hospital bill in total was $211,200 and after my deductible and co-insurance agreement it says I still owe $61,365 there is no way I can afford this. My question is why wasn't this covered in full if it was an emergency visit and surgery? "
Alec: "According to your policy we are required to cover in full every ER trip and hospital stay after your deductible. If you look at your [[bill->bills]] you will see that we did in fact cover that visit and ambulance in full. The only problem is that the hospital you were taken to was in network, but the doctor who performed your surgery was out of network. Since the doctor was out of network we are not in charge of the full payment but rather this situation will divert us to use the co-insurance where you pay 30% and we pay 70% of whatever that bill will be."
Rachel: "I don't understand I was unconscous I had no ability to choose my doctor or hospital."
Alec: "I'm sorry ma'am I cannot help you. The only help I can offer is to reccomend you call the hospital and see what payment plans are available for your bill. Thank you. Have a Nice Day!"
*With that final statement I heard the dial tone ring in my ear*
Confused, frustrated, and certaintly not happy I took a couple deep breaths before I called the [[hospital...-> Final option]]Janice:"Hello this is Janice Smith with Hospitals United. How can I help you? "
Rachel:"Hi this is Rachel Davis I was recently a patient at your hospital and my insurance told me to call you to set up a payment plan of some sort."
Janice:"Yes you've come to the right place. None of our payment plans include interest but you do have to make a payment every month. Our minimum payment plans are dependent upon your hospital bill. It says under your file that after insurance you have a remaining $61,365 that needs to be paid can you please confirm that?"
Rachel: "Yes that would be me."
Janice: "Ok awesome this high of a payment means that your payment plan will be based off of your yearly salary. What is your yearly salary Rachel?"
Rachel:"Between two jobs I make $40,000 a year."
Janice: "Ok since your bill is so high compared to your salary we will customize your payment plan by only making the yearly cost of payments equal to 3% of your salary. This means you will be paying $2,000 a year until the bill is paid. This means you will owe the hospital 167 dollars every month. Of course you can pay more than that, but that is your minimum payment plan."
Rachel: "Oh thank you soo much. You have no idea how much this helps!"
*I had found a way out! Maybe this bill wouldn't be so bad after all. That night I quickly fell [[asleep...-> Stage 3]]*
*I entered the Denny's parking lot and took a few breaths before I worked up the courage to walk through the door. The lights were off which was odd because I could have sworn I wasn't the only one in the parking [[lot...->sURPRISE]]With the dial tone ringing in my ear I had a choice to make. Do I call my Boss to make sure I still have a job or do I call the hospital to find a payment plan?
[[Call my Boss->My boss]]: Jack Bomont
[[Call the Hospital->Call Hospicetal]]: Janice SmithJanice:"Hello this is Janice Smith with Hospitals United. How can I help you? "
Rachel:"Hi this is Rachel Davis I was recently a patient at your hospital and my insurance told me to call you to set up a payment plan of some sort."
Janice:"Yes you've come to the right place. None of our payment plans include interest but you do have to make a payment every month. Our minimum payment plans are dependent upon your hospital bill. It says under your file that after insurance you have a remaining $61,365 that needs to be paid can you please confirm that?"
Rachel: "Yes that would be me."
Janice: "Ok awesome this high of a payment means that your payment plan will be based off of your yearly salary. What is your yearly salary Rachel?"
Rachel:"Between two jobs I make $40,000 a year."
Janice: "Ok since your bill is so high compared to your salary we will customize your payment plan by only making the yearly cost of payments equal to 5% of your salary. This means you will be paying $2,000 a year until the bill is paid. This means you will owe the hospital 167 dollars every month. Of course you can pay more than that, but that is your minimum payment plan."
Rachel: "Oh thank you soo much. You have no idea how much this helps!"
*I had found a way out! Maybe this bill wouldn't be so bad after all. NOw I just had to call [[Jack...-> ihb]]*
Jack: "Hey Rachel how are you? I was so scared when they rushed you to the hospital is your hand ok?"
Rachel: "Yeah I'm ok I still have a hand. You should see my medical bills it might have been better if I just lost it haha."
Jack: "Who would cook the best fries known to any Denny's chain?"
Rachel: "Right about that, can I still work at Denny's? I have some mild scarring but if I wear extra gloves it'll be like it never happened."
Jack: "I've been thinking about that and I want you to not worry about it you have been with us so long that firing you would mean more loss than gain. You're one of the best employees we have!"
Rachel: "I still have a job?"
Jack: "YES Rachel you still have a job."
Rachel:"Thank you Jack I'll be at work tomorrow!"
Jack:"Can't wait see you there!"
*With two down and one to go I started dialing the [[hospital's number->hospital #]].*Janice:"Hello this is Janice Smith with Hospitals United. How can I help you? "
Rachel:"Hi this is Rachel Davis I was recently a patient at your hospital and my insurance told me to call you to set up a payment plan of some sort."
Janice:"Yes you've come to the right place. None of our payment plans include interest but you do have to make a payment every month. Our minimum payment plans are dependent upon your hospital bill. It says under your file that after insurance you have a remaining $61,365 that needs to be paid can you please confirm that?"
Rachel: "Yes that would be me."
Janice: "Ok awesome this high of a payment means that your payment plan will be based off of your yearly salary. What is your yearly salary Rachel?"
Rachel:"Between two jobs I make $40,000 a year."
Janice: "Ok since your bill is so high compared to your salary we will customize your payment plan by only making the yearly cost of payments equal to 3% of your salary. This means you will be paying $2,000 a year until the bill is paid. This means you will owe the hospital 167 dollars every month. Of course you can pay more than that, but that is your minimum payment plan."
Rachel: "Oh thank you soo much. You have no idea how much this helps!"
*I had found a way out! Maybe this bill wouldn't be so bad after all. That night I quickly fell [[asleep...-> Stage 3]]*
Jack: "Hey Rachel how are you? I was so scared when they rushed you to the hospital is your hand ok?"
Rachel: "Yeah I'm ok I still have a hand. You should see my medical bills it might have been better if I just lost it haha."
Jack: "Who would cook the best fries known to any Denny's chain?"
Rachel: "Right about that, can I still work at Denny's? I have some mild scarring but if I wear extra gloves it'll be like it never happened."
Jack: "I've been thinking about that and I want you to not worry about it you have been with us so long that firing you would mean more loss than gain. You're one of the best employees we have!"
Rachel: "I still have a job?"
Jack: "YES Rachel you still have a job."
*I saw bright hope as I got off that phone [[call...-> CALL]]**It seemed like all I would be losing would be a couple hundred bucks and if I was careful I wouldn't have any other accidents that year. I might even end up with a gnarly Halloween hand at the end of this. Maybe I better start looking at casual gloves. None the less my pillow awaited and so did another day at [[work...-> Stage 3]].**The lights flicked on and all of the staff were there.*
"SURPRISE!!"
*There was a giant box of donuts on the table and a pair of these cute blue cooking gloves.*
Rachel: "Oh my gosh! I can't believe this! You guys are my favorite!"
Jack: "Well we had to do something for our favorite person!"
Cherise: "Oh Hon we missed you! How's your hand?"
Rachel: "It's ok um I'll have some physical therapy for a few weeks and maybe some pain pills. Other than that the doctors did a great job taking care of the nerve damage and such. I just figured I wouldn't need a left hand to flip pancakes.
Cherise: "That's good, I was afraid you might lose it. It looked like a hot mess when the newbie finally pulled you out of there."
Rachel: "The newbie pulled me out? Wasn't she the one who knocked me in?"
Cherise: "Actually... yeah but she pulled you out fast as a horse in an oatmeal bucket."
Rachel: "Is she here?"
Cherise: "Yeah do you wanna talk to her?"
Rachel: [[Yes->forgive]] [[No->be cold]]
Cherise: "Actually... yeah but she pulled you out fast as a horse in an oatmeal bucket."
Rachel: "Is she here?"
Cherise: "Yeah do you wanna talk to her?"
Rachel: "Uh... yeah. Where is she?"
Cherise: "Hol on lemme hollar. Taylor!"
*Cherise quickly gave her famous command shout and a short girl probably 18, emerged from the familiar faces of my co-workers. *
Taylor: "Hi Rachel... I'm Taylor. S-Sorry about your hand I didn't mean to knock you over. "
*The poor thing looked like she was going to die she was shaking so bad. I couldn't stand it anymore so I just...*
[[Gave her a big hug.]]
[[Showed her my shriveled hand.]]
Cherise: "Actually... yeah but she pulled you out fast as a horse in an oatmeal bucket."
Rachel: "Is she here?"
Cherise: "Yeah do you wanna talk to her?"
Rachel: "No I'm good I think I should stay away from her for a while."
Cherise: "Oh ok sure, sure."
*Overall my first day back was not bad of course I didn't have time for my second job which is just a simple dog-walking gig. I actually had to head down to the hospital to pick up my [[prescription...]]Rachel: "Hey don't worry about it. You actually saved my hand believe it or not, and any newb that's brave enough to pull me out of a fryer deserves a hug."
Taylor: "Thank you, oh my gosh I was really worried that you would hate me."
Rachel: "No I don't hate you. You did everyhting you could and it was an accident. By the time Cherise is done with you you'll be a balancing circus act."
*Overall my first day back was not bad of course I didn't have time for my second job which is just a simple dog-walking gig. I actually had to head down to the hospital to pick up my [[prescription...]]*Who are you? You chose to forgive her. Go back and try again fool.*All of my prescriptions were at the hospital I was taken too during the incident. But since it's just medication my insurance should cover me. On the way there I started thinking about the instructions that nurse gave me about my prescriptions and burn dressings*
***Nurse:"Ok the doctor prescribed you morphine and bacitracin. The bacitracin is for when you change the dressings on your hand. You need to change the dressings twice a day. Each time before you re-wrap your hand you need to spray on the bacitracin. The morphine is to help you handle th epain when you change your dressings. Usually you will take it 10 minutes before you change the dressing"***
*That was the first day I saw my hand when it looked like burnt crispy chicken. I finally made it to the hospital and walked up to the prescription counter.*
Worker: "Hi what name is your prescription under?"
Rachel: "Rachel Davis."
*The worker quickly turned to sort through the different slots until he found my name. *
Worker:"Here you go bacitracin and morphine pills. Your next pickup is scheduled in a week and a half right after your doctor's visit. That will be $20."
Rachel:"Ok here, thank you."
*I was a little peeved that I had to pay for anything at all, I bought a premium plan for cripes sake and it felt like It wasn't even [[helping...-> Final panels *]]
*The lights flicked on and all of the staff were there.*
"SURPRISE!!"
*There was a giant box of donuts on the table and a pair of these cute blue cooking gloves.*
Rachel: "Oh my gosh! I can't believe this! You guys are my favorite!"
Jack: "Well we had to do something for our favorite person!"
Cherise: "Oh Hon we missed you! How's your hand?"
Rachel: "It's ok um I'll have some physical therapy for a few weeks and maybe some pain pills. Other than that the doctors did a great job taking care of the nerve damage and such. I just figured I wouldn't need a left hand to flip pancakes.
Cherise: "That's good, I was afraid you might lose it. It looked like a hot mess when the newbie finally pulled you out of there."
Rachel: "The newbie pulled me out? Wasn't she the one who knocked me in?"
Cherise: "Actually... yeah but she pulled you out fast as a horse in an oatmeal bucket."
Rachel: "Is she here?"
Cherise: "Yeah do you wanna talk to her?"
Rachel: [[Yes-> forgive]] [[No-> be cold]]
Cherise: "Actually... yeah but she pulled you out fast as a horse in an oatmeal bucket."
Rachel: "Is she here?"
Cherise: "Yeah do you wanna talk to her?"
Rachel: "Uh... yeah. Where is she?"
Cherise: "Hol on lemme hollar. Taylor!"
*Cherise quickly gave her famous command shout and a short girl probably 18, emerged from the familiar faces of my co-workers. *
Taylor: "Hi Rachel... I'm Taylor. S-Sorry about your hand I didn't mean to knock you over. "
*The poor thing looked like she was going to die she was shaking so bad. I couldn't stand it anymore so I just...*
[[Gave her a big hug.->hugs]]
[[Showed her my shriveled hand.->the hand]]
Cherise: "Actually... yeah but she pulled you out fast as a horse in an oatmeal bucket."
Rachel: "Is she here?"
Cherise: "Yeah do you wanna talk to her?"
Rachel: "No I'm good I think I should stay away from her for a while."
Cherise: "Oh ok sure, sure."
*Overall my first day back was not bad of course I didn't have time for my second job which is just a simple dog-walking gig. I actually had to head down to the hospital to pick up my [[ prescription...->prescrip]]Rachel: "Hey don't worry about it. You actually saved my hand believe it or not, and any newb that's brave enough to pull me out of a fryer deserves a hug."
Taylor: "Thank you, oh my gosh I was really worried that you would hate me."
Rachel: "No I don't hate you. You did everyhting you could and it was an accident. By the time Cherise is done with you you'll be a balancing circus act."
*Overall my first day back was not bad of course I didn't have time for my second job which is just a simple dog-walking gig. I actually had to head down to the hospital to pick up my [[prescription...->prescrip]]*Who are you? You chose to forgive her. Go back and try again fool.*All of my prescriptions were at the hospital I was taken too. Since it's just pain medication my insurance should cover me. On the way there I started thinking about the instructions that nurse gave me about my prescriptions and burn dressings*
***Nurse:"Ok the doctor prescribed you morphine and bacitracin. The bacitracin is for when you change the dressings on your hand. You need to change the dressings twice a day. Each time before you re-wrap your hand you need to spray on the bacitracin. The morphine is to help you handle th epain when you change your dressings. Usually you will take it 10 minutes before you change the dressing"***
*That was the first day I saw my hand when it looked like burnt crispy chicken. I finally made it to the hospital and walked up to the prescription counter.*
Worker: "Hi what name is your prescription under?"
Rachel: "Rachel Davis."
*The worker quickly turned to sort through the different slots until he found my name. *
Worker:"Here you go bacitracin and morphine pills. Your next pickup is scheduled in a week and a half right after your doctor's visit. That will be $40."
Rachel:"Ok here, thanks I guess."
*I was a little peeved that I had to pay for anything at all, I bought a premium plan for cripes sake and it felt like It wasn't even helping maybe I should call that insurance agent again? Yep I'm gonna [[call him.->that's right call your passive aggresive insurance lover]]*
*Being the smart person I am I saved this living human turd's number.*
Alec: "Hi Alec Boroski speaking how can I help?"
Rachel: "Hi this is Rachel again I'd just like to ask you a quick question. Which medication am I paying for and why is my co-pay so high?"
Alec: "Ok your co-pay is $40 because you bought our Bronze plan. In the Bronze plan the premium is low which means the money is compensated whith your deductible, co-pay and co-insurance. Currently your co-pay is helping us cover your morphine medication. Since you do not necessarily need the pain medication we do not have to fully cover it. You can elect to drop it from your prescriptions. This means you won't have to do co-pay but your bacitracin will still be completely covered by us."
Rachel: "If my doctor prescribed me morphine doesn't that make it needfull?"
Alec: "No, not under our determining stipulations. Pain medications are classified as uneccessary. Your bacitracin is an example of a needfull prescription."
* T have to be able to work and I can only do that with painkillers. Still, I can't afford to shovel out $40 everytime I need medication. There is no way I can drop the morphine, I risk losing my job. *
Rachel:"Do you have any other plans I can purchase that will completely cover my medication?"
Alec: "I do it's called an Ultra Premium Plan. It will cover any medication. It also covers up to 5 doctor's visits a year and your co-insurance gets lowered to 5%"
Rachel:"Great how much is it?"
Alec:"In accordance with your previous history and the fact that you have only been with us a few [[days...->continue loverboy]] "Alec:"The Ultra Premium Package will cost you 1,500 a month and your deductible will be $150. This is a dramatic cut in your deductible I might add..."
*This guy is getting me no where.*
Should I
[[Hang up]]
[[Finish the conversation]]*That was fun!*
***Rachel Davis from then on stayed with her Bronze Plan unable to afford a better one that her insurance offered. She truly believed her only option was to switch insurance companies but many companies would not cover her because she had current medical bills. The bills she incurred from that one accident would take her 30 years to pay off unless she found a better job. She had no choices and little money. Any choice she made would lead her to bankruptcy or [[homelessness.->A Note to the Players]]Rachel:"Ok thank you for your input, but I don;t think I will be purchasing that plan. It's far too expensive. Thank you for your time."
***Rachel Davis from then on stayed with her Bronze Plan unable to afford any of the "better" ones that her insurance offered. She truly believed her only option was to switch insurance companies but many companies would not cover her because she had current medical bills. The bills she incurred from that one accident would take her 30 years to pay off unless she found a better job. She had no choices and little money. Any choice she made would lead her to bankruptcy or [[homelessness.->A Note to the Players]]A note to the players
The point of this game was to give the players scenarios and examples of how insurance generally works and how the companies can sometimes play tricks to get your money. A person always has to know how the policy works. Lots of real insurance plans will have specific categories that they cover and a consumer has to know each and every category to be able to get the right insurance for them. Every private insurance plan is different and shopping around for the best one is often the best choice consumers can make. This of course is different from group plans that are normally offered by employers as an incentive. The examples in the game given were simply general ideas based on true facts and plausable scenarios, as the creator I took the liberty of distorting them in certain cases for creative effect. All of the sources used for the game are listed below.
“Agent and Broker (Health Insurance).” HealthCare.gov, www.healthcare.gov/glossary/agent/. Accessed 12 April 2020.
“FIX IT - Healthcare At The Tipping Point. ” YouTube, uploaded by Unfinished Business, 4 July 2016, www.youtube.com/watch?v=44ZDpYjKVAU.
Fontinelle, Amy. “Buying Private Health Insurance.” Investopedia, 15 October 2019,www.investopedia.com/articles/pf/08/private-health-insurance.asp. Accessed 13 April 2020.
Kagan, Julia. “Insurance Premium.” Investopedia, 20 May 2019, www.investopedia.com/terms/i/insurance-premium.asp. Accessed 13 April 2020.
“Open Enrollment Walkthrough.”YouTube, uploaded by HealthWatch Wisconsin, 11 November 2019, www.youtube.com/watch?v=sC1ngM2HCdE.
Price, Sterling. “Copays vs Coinsurance for Health Insurance.” ValuePenguin, 27 MArch 2020, www.valuepenguin.com/copay-vs-coinsurance. Accessed 13 April 2020.
Suh, Elissa. “What does a deductible mean in health insurance?.” Policygenius, 10 January 2020, www.policygenius.com/health-insurance/health-insurance-deductible/. Accessed 12 April 2020.
*The next few weeks included lots of painful dressing changes and healing. I got along fine with just my right hand at work, but I could have been in serious trouble wiith those medical bills. Luckily I picked the right insurance [[ plan...->A Note to the Players]]*